Fertisuisse AG, Clinic for Reproductive Medicine, Basel, Switzerland; Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia; Oncofertility Program, Royal Children's Hospital, Parkville, Victoria, Australia.
Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia; Oncofertility Program, Royal Children's Hospital, Parkville, Victoria, Australia; Reproductive Services, Royal Women's Hospital, Parkville, Victoria, Australia.
Reprod Biomed Online. 2023 Aug;47(2):103232. doi: 10.1016/j.rbmo.2023.05.004. Epub 2023 May 9.
Is there potential for the detection of neuroblastoma malignancy in testicular tissue extracted for fertility preservation for prepubertal boys at the time of tissue freezing?
This is a case report.
A boy was diagnosed with primary localized left adrenal neuroblastoma, with complete resection of the tumour. During 6 months' surveillance, he developed a relapse in the left para-renal region with progression of molecular and chromosomal features into undifferentiated neuroblastoma. Before highly gonadotoxic treatment, testicular biopsy for fertility preservation was taken, from a clinically normal testis. Histopathological examination of the testicular biopsy revealed metastatic neuroblastoma.
Metastatic neuroblastoma detected histologically in a clinically normal testis highlights the importance of routine histological examination at the time of testicular cryopreservation. The histological evaluation of gonadal tissue for potential malignant contamination before freezing should be mandatory, regardless of the malignancy diagnosis. Advances in sensitive molecular detection and in-vitro maturation are critically required to decrease future risk of disease recurrence in both solid and haematological malignancies.
在为青春期前男孩进行组织冷冻以保留生育能力时，从提取的睾丸组织中是否有可能检测到神经母细胞瘤的恶性程度？
这是一个病例报告。
一名男孩被诊断为原发性局限性左肾上腺神经母细胞瘤，肿瘤完全切除。在 6 个月的监测期间，他在左肾旁区复发，分子和染色体特征进展为未分化神经母细胞瘤。在进行高度性腺毒性治疗之前，进行了睾丸活检以保留生育能力，取自临床正常的睾丸。睾丸活检的组织病理学检查显示转移性神经母细胞瘤。
在临床正常的睾丸中通过组织学检测到转移性神经母细胞瘤，这突出了在进行睾丸冷冻时常规进行组织学检查的重要性。无论恶性肿瘤的诊断如何，在冷冻前对生殖组织进行潜在恶性污染的组织学评估都应是强制性的。迫切需要在敏感的分子检测和体外成熟方面取得进展，以降低实体瘤和血液系统恶性肿瘤未来疾病复发的风险。
